CASE REPORT |
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Year : 2014 | Volume
: 9
| Issue : 2 | Page : 172-174 |
Neuroretinitis with abnormal brain imaging in Ask-Upmark kidney: A novel case report
Gaurav M Kasundra1, Isha Sood2, Sanjay Prakash3, Dhruv P Mehta4
1 Department of Neurology, Dr. Sampurnanand Medical College and Mahatma Gandhi Hospital, Jodhpur, Rajasthan, India 2 Department of Medicine, Dr. Sampurnanand Medical College and Mahatma Gandhi Hospital, Jodhpur, Rajasthan, India 3 Department of Neurology, Smt. B. K. Shah Medical College, Baroda, India 4 Department of Medicine, Medical College, Baroda, Gujarat, India
Correspondence Address:
Gaurav M Kasundra 122, Subhash Nagar, Pal Road, Jodhpur - 342 008, Rajasthan India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1817-1745.139347
We report a 13-year-old female patient having vertigo and visual blurring since 2 weeks with blood pressure being 180/106 mmHg. Fundus examination showed optic disc edema with macular star. After ruling out infective causes, idiopathic neuroretinitis was diagnosed. Her brain magnetic resonance imaging (MRI) scan revealed three periventricular morphologically multiple sclerosis (MS)-like white matter lesions. Renal ultrasound and renal arteriogram showed a shrunken left kidney, small non-stenotic left renal artery and reduced vessels in upper pole of left kidney, consistent with Ask-Upmark kidney (AUK). Her symptoms improved with antihypertensive drugs. Follow-up MRI at 1 year revealed no interval change, while fundus had normalized. Neuroretinitis typically has normal brain MRI and rules out MS. However, our patient having AUK-induced hypertension had neuroretinitis and MS-like brain lesions and did not fulfill diagnostic criteria for MS. Thus we postulate that MS-like lesions can be part of neuroretinitis, especially in hypertensive patients.
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